title: Comparison of local anesthetic efficacy of tramadol hydrochloride (with adrenaline) versus plain tramadol hydrochloride in the extraction of upper molar teeth.
abstract: OBJECTIVE
  To evaluate the efficacy of local anesthesia using tramadol hydrochloride (HCl) with versus without adrenaline in the extraction of upper molar teeth.
  
  
  METHODS
  This was a double-blinded study that included 100 patients who required extraction of 1 upper molar by the conventional method and were allocated randomly into 1 of 2 groups: in group A (n = 50), each patient received an initial dose of drug A (tramadol HCl 50 mg and adrenalin 0.0225 mg diluted to 1.8 mL by distilled water); in group B (n = 50), each patient received an initial dose of drug B (tramadol HCl 50 mg diluted to 1.8 mL by distilled water). Degree of pain during tooth extraction, duration of surgery, and total number of cartridges used were recorded intraoperatively. Postoperatively, patients were instructed to record any adverse effects, such as nausea or vomiting, on the first day of the operation.
  
  
  RESULTS
  There were significant differences in the number of cartridges used and the degree of intraoperative pain. However, there was no significant difference in duration of surgery or side effects.
  
  
  CONCLUSIONS
  The results of this study suggest that tramadol HCl in combination with adrenaline can be used as an alternative local anesthetic in oral and maxillofacial surgery when, for some unusual reason, a patient cannot receive a conventional local anesthetic.
authors.affiliation: Assistant Lecturer, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Mosul, Mosul, Iraq. Electronic address: Dr.yahya1978@yahoo.com.
authors.forename: Yahya A A
authors.initials: YA
authors.lastname: Al-Haideri
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D004837:Epinephrine / Q000009:adverse effects / Q000627:therapeutic use*; D005157:Facial Pain / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D008963:Molar / Q000601:surgery*; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced; D018709:Statistics, Nonparametric; D014081:Tooth Extraction / Q000009:adverse effects; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D014662:Vasoconstrictor Agents; D014147:Tramadol; D004837:Epinephrine